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This is VAERS ID 620134

Case Details

VAERS ID: 620134 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-12-23
Entered: 2015-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal distension, Abdominal pain, Cognitive disorder, Constipation, Diarrhoea, Dizziness, Dry eye, Dyspnoea, Dysuria, Fatigue, General physical health deterioration, Headache, Hyperhidrosis, Hyperventilation, Influenza, Muscular weakness, Myalgia, Nausea, Neuralgia, Orthostatic intolerance, Palpitations, Photophobia, Presyncope, Sensory disturbance, Sleep disorder, Tilt table test positive, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: Tilt table test at syncope center hospital, is orthostatic intolerance seen but the patient does not fulfill the diagnostic criteria for POTS.
CDC Split Type: WAES1512DNK011536

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer control # 2015001269) on 22-DEC-2015. Case received from a physician via health authority on 18-Dec-2015 under reference number DK-DKMA-WBS-0002091. A 18-year-old female adult patient received GARDASIL, (batch number unknown) via intramuscular route on 21-Aug-2013, GARDASIL, (batch number unknown) via intramuscular route on 21-Aug-2013, GARDASIL, (batch number unknown) via intramuscular route on 21-Sep-2012, GARDASIL, (batch number unknown) via intramuscular route in 2007. The patient experienced Fatigue extreme in DEC-2007, Flu symptoms on an unknown date, Headache on an unknown date, Muscle pain on an unknown date, Joint pain on an unknown date, Neuropathic pain on an unknown date, Near syncope on an unknown date, Dizziness in DEC-2007, Palpitation on an unknown date, Nausea on an unknown date, Abdominal pain on an unknown date, Obstipation on an unknown date, Diarrhea on an unknown date, Voiding dysfunction on an unknown date, Dyspnoea on an unknown date, Hyperventilation on an unknown date, Sleep disorder on an unknown date, Cognitive dysfunction on an unknown date, Limb weakness on an unknown date, Sensory disturbance in arms and legs on an unknown date, Sweating abnormal on an unknown date, Dry eyes on an unknown date, Feeling bloated on an unknown date, Blurred vision on an unknown date, Light sensitivity to eyes on an unknown date, Orthostatic intolerance on an unknown date, reduced general function on an unknown date and it has taken 7 years to do a secondary education on an unknown date. She can not remember if she has received 4 or 5 doses. She got the first dose during the period March-June 2007 and maybe one more 2 months later. She did not got the third dose. Since she had not been fully vaccinated in 2007, she got three doses in 2012-2013. First symptoms Christmas 2007, is remarkable tired and dizzy. Afterwards the other symptoms. Tilt table test shows orthostatic intolerance, but she did not fulfill the criteria for POTS. The patient describes a reduced general function and has had a lot of sick leave. It took 7 years to perform the secondary education. Other medicines or vaccines: Unknown. Additional investigations included Tilt Table Test orthostatic intolerance on an unknown date. The patient''s outcome was reported as Not Recovered/Not Resolved. Upon medical review the company decided to code the extra dose given and vaccination error.

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